<%-- 
    Document   : WUIRegistroPaciente
    Created on : 07-nov-2012, 23:07:32
    Author     : Windows7
--%>

<%@page contentType="text/html" pageEncoding="UTF-8"%>
<!DOCTYPE html>
<html>
    <head>
        <meta http-equiv="Content-Type" content="text/html; charset=UTF-8">
        <title>JSP Page</title>
    </head>
    <body>
        <form name="reg" action="RegistroControl" method="post">
            <p align="center"><font size="6"><B>Creacion de Nuevo Paciente</B></font></p>
            <p align="center">
            <TABLE BORDER=0>
            <TR>
              <TD><font size="3">Nombre:</font></TD>
              <TD><input type="text" name="nombre" size="40"></TD>
            </TR>
            <TR>
              <TD><font size="3">Apellido:</font></TD>
              <TD><input type="text" name="apellido" size="40"></TD>
            </TR>
            <TR>
              <TD><font size="3">DNI:</font></TD>
              <TD><input type="text" name="dni" size="8"></TD>
            </TR>
            <TR>
              <TD><font size="3">Fecha de Nacimiento:</font></TD>
              <TD><input type="text" name="fecnac" size="10"></TD>
            </TR>
            <TR>
              <TD><font size="3">Sexo:</font></TD>
              <TD><SELECT name="sex">
              <OPTION VALUE="M">Masculino
              <OPTION VALUE="F">Femenino
              </SELECT>
              </TD>
            </TR>
            <TR>
              <TD><font size="3">Direccion:</font></TD>
              <TD><input type="text" name="direc" size="120"></TD>
            </TR>
            
            <TR>
              <TD><font size="3">Telefono:</font></TD>
              <TD><input type="text" name="telefono" SIZE=8 MAXLENGTH=16></TD>
            </TR>
            <TR>
              <TD><font size="3">Tipo de Sangre:</font></TD>
              <TD><input type="text" name="tiposan"></TD>
            </TR>        
            
            </TABLE>
            </p>
            <p align="center">
            <input type="submit" value="Enviar">&nbsp;&nbsp;
            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <input type="reset" value="Borrar">
            </p>
        </form>
    </body>
</html>
